Question: I had the Epstein-Barr virus some time back. Can you tell me the cause and if it will return, the way they say? I also hear about chronic fatigue syndrome. Is that the same thing?
- O.V.J.Answer: The Epstein-Barr virus causes a mononucleosis infection, to which most adults have been exposed. Most get over its sore throat, fatigue, fever and swollen glands in a couple of weeks. Many never realize they were exposed to mono. But the virus does remain in the body thereafter.
Chronic fatigue syndrome is a recent entity, in which patients report recurring cycles of fatigue, muscle ache and headaches. CFS was once thought to be reactivation of the mono virus. Today, most authorities deny such a link. In fact, the cause of CFS is not known.
Now, an extremely small number of people may have reactivation of the old Epstein-Barr virus. They feel washed out, with recurring mild sore throats and low-grade fevers.
It sounds as though we are making a distinction without a difference. Not so. The extremely rare mono reactivation illness is real and can be proved in individual cases. Chronic fatigue syndrome symptoms, whatever their cause, are also real, but they have nothing to do with the old mono virus.
Faced with symptoms, a doctor arrives at a CFS diagnosis by eliminating provable causes, from anemia to the rare Epstein-Barr reactivation.
When I discuss this, I get mail from irate CFS patients who take me to task for denying their illness. They are ill, all right, but only in rare cases are their old mono viruses reactivated. Something unknown is causing their fatigue.
Beyond rest, there is no treatment to eradicate mono, its later rare virus re-emergence or CFS. Exercise prevents muscle wasting.
Research continues in an effort to pin down a cause for CFS.
Question: Please explain the best way to diagnose low blood sugar besides the six-hour glucose test.
Answer: One way is to have your blood sugar tested while you are having actual symptoms. That is not far-fetched. You don't have to rush to a lab. Just ask the doctor about taking a pinprick blood sample. You blot that on a special paper for later analysis.
Testing is discussed in my report on low blood sugar. Other readers can order a copy by writing: Dr. Donohue - No. 19, P.O. Box 5539, Riverton, NJ 08077. Enclose a long, self-addressed, stamped (52 cents) envelope and $3.
Question: My 8-year-old granddaughter's skin is very pale. However, her mother says she does not show anemia. Could there be something lacking in her diet? She spends average time out of doors at play.
Answer: Skin color is not a reliable sign of anemia. Some babies are born with naturally pale color. Since your granddaughter has been checked and been found healthy, you should not worry.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him at P.O. Box 5539, Riverton, NJ 08077.
1993 North America Syndicate Inc.